LAS VEGAS AMG SPECIALTY HOSPITAL
1. Target Overview & Investment Thesis
LAS VEGAS AMG SPECIALTY HOSPITAL is a 24-bed community hospital in CLARK, NV with $8.7M in net patient revenue and a 4.4% operating margin. The hospital serves a payer mix of 54.3% Medicare, 0.0% Medicaid, and 45.7% commercial.
Thesis: Turnaround. Our ML models identify $645K in annual EBITDA improvement potential from RCM optimization across 5 levers, lifting margin from 4.4% to 11.8% (+745bps).
| Net Revenue HCRIS | $8.7M |
| Current EBITDA COMPUTED | $377K |
| Operating Margin COMPUTED | 4.4% |
| Occupancy HCRIS | 39.5% |
| Revenue / Bed COMPUTED | $361K |
| Net-to-Gross HCRIS | 54.0% |
| Distress Probability ML | nan% |
2. Market Context & Competitive Position
NV has 58 Medicare-certified hospitals with a median operating margin of 0.4%. The target's margin of 4.4% places it above the state median. Among 15 size-comparable peers (12-48 beds), the median margin is -4.2%. The target performs in line with or above peers.
3. RCM Performance Analysis — Comparable Hospitals
Comps selected by bed count (12-48), prioritizing same-state peers. 15 hospitals in the comp set.
| Hospital | State | Beds | Revenue | Margin |
|---|---|---|---|---|
| LAS VEGAS AMG SPECIALTY HOSPIT (Target) | NV | 24 | $8.7M | 4.4% |
| CARSON VALLEY MEDICAL CENTER | NV | 23 | $84.3M | 6.8% |
| BANNER CHURCHILL COMMUNITY HOS | NV | 25 | $69.2M | 6.8% |
| DIGINTY HEALTH ST ROSE DOMINIC | NV | 32 | $61.5M | 12.2% |
| HUMBOLDT GENERAL HOSPITAL | NV | 25 | $58.8M | -37.3% |
| PAM REHAB HOSP OF CENTENNIAL H | NV | 44 | $35.7M | 29.1% |
| WILLIAM BEE RIRIE HOSPITAL | NV | 25 | $35.1M | -17.9% |
| MESA VIEW REGIONAL HOSPITAL | NV | 25 | $34.9M | -4.2% |
| DESERT VIEW REGIONAL MEDICAL C | NV | 25 | $34.4M | 2.0% |
4. Predicted Improvement Opportunities
Improvement targets set at P75 of comparable peers with 60% gap closure assumption. Coefficients calibrated to published research bands. Total EBITDA uplift: $645K (745bps margin improvement).
| Lever | Current | Target | EBITDA Impact | Margin | Ramp |
|---|---|---|---|---|---|
| Net Collection Rate | 93.5% | 97.0% | $182K | +210bp | 18mo |
| Denial Rate Reduction | 12.0% | 6.5% | $175K | +202bp | 12mo |
| Cost to Collect | 4.5% | 2.5% | $173K | +200bp | 12mo |
| A/R Days Reduction | 5200.0% | 3800.0% | $105K | +122bp | 9mo |
| Clean Claim Rate | 88.0% | 96.0% | $10K | +11bp | 6mo |
5. EBITDA Bridge
| Current EBITDA | $377K |
| + RCM Uplift | +$645K |
| Pro Forma EBITDA | $1.0M |
| Current Margin | 4.4% |
| Pro Forma Margin | 11.8% |
| WC Released (1x) | $332K |
6. Returns Analysis — Scenario Matrix
5-year hold, 5.5x leverage, 3% organic growth, 10%/yr debt paydown. Base case uses 100% of predicted RCM uplift. Bull case: 130% uplift at lower entry. Bear case: 50% uplift at higher entry.
| Scenario | Entry | Exit | Equity In | Equity Out | MOIC | IRR |
|---|---|---|---|---|---|---|
| Base Case | 10.0x | 10.0x | $580K | $8.9M | 15.41x | 72.8% |
| Base (11x exit) | 10.0x | 11.0x | $580K | $10.0M | 17.28x | 76.8% |
| Bull Case | 9.0x | 11.0x | $522K | $12.3M | 23.63x | 88.2% |
| Bull (12x exit) | 9.0x | 12.0x | $522K | $13.6M | 26.08x | 92.0% |
| Bear Case | 11.0x | 10.0x | $638K | $5.5M | 8.66x | 54.0% |
| Bear (11x exit) | 11.0x | 11.0x | $638K | $6.3M | 9.85x | 58.0% |
7. Key Risks & Mitigants
| Severity | Risk Factor | Mitigant |
|---|---|---|
| Medium | Standard execution risk | RCM improvement requires management buy-in and 12-18 month implementation timeline |
8. Data Sources & Methodology Appendix
Data Sources
- CMS HCRIS Cost Reports (Medicare-certified hospitals)
- CMS Medicare Utilization (DRG-level volumes)
- CMS Chronic Conditions (county-level disease prevalence)
- HCRIS multi-year trend data (financial time series)
Comparable Selection
- 15 hospitals with 12-48 beds
- Same-state prioritization (n=16)
- Comp margins: P25=-18.8% / P50=-4.2% / P75=9.3%
Bridge Methodology
- Targets: P75 of comparable peers (60% gap closure)
- Denial: avoidable share = 35% of delta × NPR
- AR: bad debt coefficient = $0.65 per day per $1K NPR
- NCR: 60% coefficient on collection rate improvement
- CDI: 0.75% of Medicare revenue per 0.01 CMI point
Returns Assumptions
- Leverage: 5.5x entry (84.6% debt / 15.4% equity)
- Organic growth: 3% annual EBITDA growth
- Debt paydown: 10% of principal per year
- Hold period: 5 years
Generated by SeekingChartis on April 26, 2026. All predictions use public data only. Confidence intervals calibrated via split conformal prediction (90% coverage target). This memo is for informational purposes and does not constitute investment advice.